SOCIAL SECURITY vs PRIVATE HEALTHCARE

[Owen]

I have just had sight of some of the recent mails on this subject and at the risk of complicating things further i thought II would make a contribution. Part of my work necessitates me having a knowledge of the French health system and the comparatively recent CMU legislation. I am not a lawyer!

The Law. Two pieces of legislation came into force on 1 Jan 2000.. CMU Law 99-641 of 27 July 1999 provided for universal healthcover for all residents of France (regardless of nationality) if they hitherto had no entitlement to state healthcare. It furhter provided free healthcare for all those families on low incomes. This is all good socialist stuff.

Law D.D.O.S of 4 February 1995 is a different matter. This provided for fines and/or imprisonment for those who issued (insurance companies) and those who purchased private health insurance policies that took the place of cover that would otherwise be granted by the state. There are special exceptions to this law eg; diplomatic staff, but they are few and far between. (Not having an E106 and being below state retirement age is not in itself an exempt category).

Of course this legislatiion was directed at French nationals and was not targeted at expats but naturally we are just as much legal residents of France as the natives and the law applies.

Having said all that like any law in France it is one thing to have it on the statute book and quite another in how it is interpreted or enforced. I am not suggesting the law should be ignored completely but individuals do have a degree of flexbility on how they approach this legislation and in particular WHEN they affiliate. I did see mention of the Exeter Friendly Society website and I would say that whilst they obviously have a knowledge of this legislation the brochure that I have illustrates a less than encylopaedic grasp of the subject.
,
E Form 106 121 etc. For those coming to France from another EU state these forms entitle the holders to a level of healthcare in France. I have produced my own paper on this subject and will be happy to send a copy to those who wish it.

Affiliation to CPAM under residence criteria only. For those that cannot affilate via E Forms then residence criteria is the only option. But this involves a contribution, whereas E Forms do not. The contribution is calculated as 8% of the difference between the threshold of 6505 Euros and worldwide income less allowances. This theshold is per HOUSEHOLD and not per person. For those who have completed a French tax return this is easy because on your avis dimpot there is the revenu fiscal de reference. and your contribution will be based on 8% of the difference between this figure and 6505 Euros.





If you have not filled in a return then other evidence of income will need to be produced.; pension statements etc. Proof of tax paid in another jurisdiction should be taken into account and most CPAM offices will do so but not all. Certainly up to the early part of this year the CPAM office in Perigieux was calculating any contribution on gross income (for those who had not completed a French tax return).

Entitlement to free healthcare. However one affiliates to CPAM only a proportion of the costs will be covered by the state (typically 70%) so most residents take out a mutuelle or police complementaire to cover the difference. The CMU legislation provides for free healthcare to the poorest of families. The thresholds for qualification are different to those of a financial contribution. But great care should be taken in trying to apply for this benefit because your case will not simply be based on your revenu fiscal de reference. For example, if you are living rent free in the house of a relative the rent , you would have to pay otherwise, may be taken into account to take you above the threshold and thus disqualify you..

This is a summary but individual circumstances are just that and this mail cannot hope to address all these but it is a start.

Peter Owen
email: [email protected]

[Teamedup]

LAST EDITED ON 20-Nov-02 AT 06:51 PM (GMT)

Thankyou for that.

I was really pleased when the Jospin government brought out CMU, there was a woman I know in our village who could not afford to contribute to the CPAM so had no state health care cover for herself and her two daughters, she has now ofcourse.

[martinetchris]

Peter

Can I second TeamedUp thanks - in particular the details of the legislation (with sources/references) helps to clarify things no end !

Best wishes

Chris and Martin

[LaBucherie]

LAST EDITED ON 21-Nov-02 AT 08:14 AM (GMT)

>The contribution is calculated as
>8% of the difference between
>the threshold of 6505 Euros
>and worldwide income less allowances.
> This theshold is per
>HOUSEHOLD and not per person.


Very helpful info -many thanks. Could you please confirm the above. My understanding was that there was an allowance of about 10500 euros for a married couple, but I can't remember where I read it. I have received my first assessment for the cotisation and it has been calculated as you have said. I have written to CPAM querying it, but have not yet received a reply. If I am mistaken, it would be nice to know before I start arguing with them!

regards
David